多种神经组织修复成鼠脊髓损伤的实验研究

背景脊髓损伤后以游离周围神经片断(雪旺氏细胞)与胚胎脊髓联合移植能协同诱发宿主再生潜能,而带血管蒂周围神经移植后有更多的雪旺氏细胞存活,但其与胚胎脊髓协同作用的研究较少.目的探讨不同神经组织移植修复成鼠急性脊髓损伤的能力.设计单盲随机对照实验.地点和对象实验在解放军第三军医大学大坪医院全军战创伤中心骨创伤科完成,研究对象为150只4月龄雌性Wistar属成年大鼠,由解放军第三军医大学实验动物中心提供.干预成鼠胸髓损伤后,分别移植游离正中神经(FPN组)、带血管蒂正中神经(VPN组)、孕14天胚胎脊髓(FSC组)、游离正中神经加胚胎脊髓(P+F组)、带血管蒂正中神经加胚胎脊髓(V+F组).主要观察指标术后8周行神经解剖及电生理检查.结果V+F组再生轴突和存活雪旺氏细胞数目、胚胎脊髓体积增长速度和神经元密度显著高于对照组(P＜0.01),细胞分化较好,突触较成熟o SEP的P1,N1波潜伏期显著缩短(P＜0.01).结论带血管蒂周围神经与胚胎脊髓联合移植,在解剖和电生理上均优于其他组织,对FSC的生长发育及损伤神经元的再生能力均有一定的促进作用.

An experimental study on the multiple nervous tissues repairing spinal cord injury in adult rats

BACKGROUND: United transplantntion of free peripheral nervous fragment (Schwann cell, SC) and fetal spinal cord(FSC) after spinal cord injury(SCI)can synergistically induce the regeneration potential in host; and furthermore, more SC will survive after the transplantation of vascularized peripheral nerves(VPN), however, few researches about its synergistic reactions with fetal spinal cord.OBJECTIVE: To discuss the repair abilities of different nervous tissue transplantation in acute SCI in adult rat.DESIGN: A single-blind randomized controlled study was performed.SETTINGS and PARTICIPANTS: The study was completed in the Department of Orthopaedics and Traumatology, Center for War Injury of Daping Hospital, Third Military Medical University. Totally 150 4-month-old female Wistar adult rats provided by Center for Experimental Animals of Third Military Medical University.INTERVENTIONS: After injury in thoracic spinal cord, these adult rats were transplanted respectively with free median nerve(FPN group), vascularized median nerve(VPN group), 14-day pregnancy fetal spinal cord(FSC group), free median nerve and fetal spinal cord(P + F group), and vascularized median nerve and fetal spinal cord(V + F group).MAIN OUTCOME MEASURES: Nervous anatomy and electrophysiologicai examination were examined after 8-week surgery.RESULTS: The numbers of regenerated axons and survived SCs, growingspeed of fetal spinal cord volume as well as the density of neurons in V + F group were significantly higher than that of control group( P ＜ 0. 01 ) with better differentiation and more mature synapse. The latencies of P1 and N1 wave of somatosensory evoked potentials (SEP) examination were significantly shortened( P ＜ 0.01).CONCLUSION: The united transplantation of vascularized peripheral nerve and fetal spinal cord is better than other tissues on anatomy and electrophysiology, which has certain promoting reactions on growth and development of FSC and the repair ability of injured neuron.